Nonalcoholic fatty liver disease and sarcopenia: pathophysiological connections and therapeutic implications

Fernández-Mincone, Tiziana; Contreras-Briceño, Felipe; Espinosa-Ramírez, Maximiliano; García-Valdés, Patricio; López‐Fuenzalida, Antonio; Riquelme, Arnoldo; Arab, Juan Pablo; Cabrera, Daniel; Arrese, Marco; Barrera, Francisco

doi:10.1080/17474124.2020.1810563

Cited by 17 publications

(12 citation statements)

References 170 publications

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“… 21 Potential pathogenic connections between NAFLD and muscle mass may be complex, bidirectional and synergistic; however, a cause–effect relation remains to be determined. 22 Until present, there have been few data regarding the converse relationship between hepatic steatosis and muscle mass, as an outcome variable. Chung et al showed that hepatic steatosis assessed using a CAP was independently associated with low muscle mass in a dose‐dependent manner.…”

Section: Discussionmentioning

confidence: 99%

“…Growing evidence has shown that low skeletal muscle mass may play a role in the risk of NAFLD as well as its advanced stages 21 . Potential pathogenic connections between NAFLD and muscle mass may be complex, bidirectional and synergistic; however, a cause–effect relation remains to be determined 22 . Until present, there have been few data regarding the converse relationship between hepatic steatosis and muscle mass, as an outcome variable.…”

Section: Discussionmentioning

confidence: 99%

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The relationship between metabolic dysfunction‐associated fatty liver disease and low muscle mass in an asymptomatic Korean population

Seo

Cho

Kim

et al. 2022

J cachexia sarcopenia muscle

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Background Metabolic (dysfunction)‐associated fatty liver disease (MAFLD) emphasizes the metabolic dysfunction in nonalcoholic fatty liver disease (NAFLD). Although the relationship between low muscle mass and NAFLD has been suggested, the effect of MAFLD on low muscle mass is yet to be investigated. In this study, we examined the relationship between MAFLD and low muscle mass in an asymptomatic Korean population. Methods Examinees who underwent FibroScan® and bioelectrical impedance analyses on the same day during the period of June 2017 to December 2019 were included. Hepatic steatosis was diagnosed using controlled attenuation parameter (CAP) with two cut‐off values of 248 and 294 dB/m. Low muscle mass was defined based on appendicular skeletal muscle mass/body weight (wt) or body mass index (BMI) ratios of two standard deviations below the sex‐specific mean for healthy young adults. Subjects were divided into four subgroups: diabetic MAFLD (presence of diabetes mellitus [DM]), metabolic dysfunction (MD) MAFLD (≥2 metabolic abnormalities without DM), overweight MAFLD (overweight/obese without DM and <2 metabolic abnormalities) and no MAFLD. Results Among all of the 6414 subjects (mean 53.9 years of age; 85.4% male), the prevalence of MAFLD was 49.9% and 22.7% for CAP cut‐off values of 248 and 294 dB/m, respectively. In the multivariate analysis, MAFLD was associated with an increased risk of both low muscle mass_wt (odds ratio [OR] 1.80, 95% confidence interval [CI] 1.38–2.35, P < 0.001) and low muscle mass_BMI (OR 1.31, 95% CI 1.01–1.70, P = 0.042). The risk of low muscle mass_wt and low muscle mass_BMI increased the most in the diabetic MAFLD subgroup compared with the no‐MAFLD group (OR 2.11, 95% CI 1.51–2.96, P < 0.001 and OR 1.51, 95% CI 1.08–2.13, P = 0.017). There was an increased risk of low muscle mass_wt in the MD MAFLD subgroup (OR 1.73, 95% CI 1.31–2.28, P < 0.001). Comparable results were observed when the CAP cut‐off value of 294 dB/m was applied. Conclusions The presence of MAFLD is significantly associated with increased risk of low muscle mass with varying risks according to the MAFLD subgroups. Clinicians should be aware of the differentiated risk of low muscle mass across the subgroups of MAFLD.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The relationship between metabolic dysfunction‐associated fatty liver disease and low muscle mass in an asymptomatic Korean population

Seo

Cho

Kim

et al. 2022

J cachexia sarcopenia muscle

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“…Because of anabolic resistance, current nutritional supplementation methods have not been successful in reversing sarcopenia[ 66 , 67 ]. The association between CHC infection of the liver and muscle loss is well documented[ 68 , 69 ]. High body mass index, IR, diabetes, hepatic steatosis, increased inflammation, increased oxidative stress, lipotoxicity, and multiple factors involved in muscle depletion all are considered as independent risk factors that predispose patients with CHC to skeletal muscle disorders[ 70 - 73 ].…”

Section: Skeletal Musclementioning

confidence: 99%

Metabolic aspects of hepatitis C virus

El-Kassas¹,

Awad²

2022

WJG

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Many metabolic factors are associated with chronic hepatitis C virus (HCV) infection and can influence the course of the illness and impact the progression of liver and non-liver-related diseases through complex interactions. Several of these factors impact the course of chronic HCV (CHC) and result in the conceptual translation of CHC from a localized to systemic disease. Besides the traditional liver manifestations associated with CHC infection, such as cirrhosis and hepatocellular carcinoma, various extrahepatic disorders are associated with HCV infection, including atherosclerosis, glucose and lipid metabolic disturbances, alterations in the iron metabolic pathways, and lymphoproliferative diseases. The coexistence of metabolic disorders and CHC is known to influence the chronicity and virulence of HCV and accelerates the progression to liver fibrosis and hepatocellular carcinoma. Insulin resistance is one of the key factors that have a tremendous metabolic impact on CHC. Therefore, there is a great need to properly evaluate patients with CHC infection and correct the modifiable metabolic risk factors. Furthermore, patients with HCV who achieved a sustained virological response showed an overall improvement in glucose metabolism, but the exact evidence still requires further studies with long-term follow-up. This review delineates the most recent evidence on the main metabolic factors associated with CHC and the possible influence of chronic HCV infection on metabolic features.

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“…Several studies have underscored that sarcopenia (i.e., decreased muscle mass) or adverse muscle composition (i.e., low muscle volume and muscle fat infiltration or myosteatosis) may influence both NAFLD development and progression. [66][67][68] Although important methodological differences exist across published studies, not all patients with NAFLD exhibit muscle alterations and it is likely that this pathogenic factor be more relevant in particular populations, such as nonobese or lean NAFLD, as well as older patients in which sarcopenia is more frequent. 69 Activation of the innate immune system has been implicated in NAFLD progression.…”

Section: Differential Contribution Of Pathogenetic Pathwaysmentioning

confidence: 99%

Insights into Nonalcoholic Fatty-Liver Disease Heterogeneity

et al. 2021

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The acronym nonalcoholic fatty-liver disease (NAFLD) groups a heterogeneous patient population. Although in many patients the primary driver is metabolic dysfunction, a complex and dynamic interaction of different factors (i.e., sex, presence of one or more genetic variants, coexistence of different comorbidities, diverse microbiota composition, and various degrees of alcohol consumption among others) takes place to determine disease subphenotypes with distinct natural history and prognosis and, eventually, different response to therapy. This review aims to address this topic through the analysis of existing data on the differential contribution of known factors to the pathogenesis and clinical expression of NAFLD, thus determining the different clinical subphenotypes observed in practice. To improve our understanding of NAFLD heterogeneity and the dominant drivers of disease in patient subgroups would predictably impact on the development of more precision-targeted therapies for NAFLD.

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Nonalcoholic fatty liver disease and sarcopenia: pathophysiological connections and therapeutic implications

Cited by 17 publications

References 170 publications

The relationship between metabolic dysfunction‐associated fatty liver disease and low muscle mass in an asymptomatic Korean population

The relationship between metabolic dysfunction‐associated fatty liver disease and low muscle mass in an asymptomatic Korean population

Metabolic aspects of hepatitis C virus

Insights into Nonalcoholic Fatty-Liver Disease Heterogeneity

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